Oral vs intravenous APAP administration on postoperative day 1 was associated with a greater reduction of opioid use.

Intravenous administration of acetaminophen (APAP) may be less effective than oral administration of APAP for reducing opioid use after total hip or knee arthroplasty (THA/TKA), according to a study published in Regional Anesthesia and Pain Medicine.

Data from the Premier Healthcare claims database on THA/TKA procedures performed between 2011 and 2016 were examined (n=1,039,647). Researchers determined whether intravenous or oral APAP was used on the day of surgery, as well as on postoperative day 1 and thereafter. Length and cost of hospitalization, opioid-related adverse effects, and opioid use, as reported in oral morphine equivalents, were the outcomes of the analysis.

A total of 245,454 patients (23.6%) were administered intravenous APAP, and 56.3% of these patients were treated with 1 dose on the day of surgery. In the adjusted analysis, the use of >1 dose of intravenous APAP on postoperative day 1 was associated with a 6.0% reduction in opioid use compared with no use (95% CI, −7.2% to −4.7%). Oral vs intravenous APAP administration on postoperative day 1 was associated with a greater reduction of opioid use (10.7% reduction; 95% CI, −11.4% to −9.9%).